When Aorta looks like a railway track . . . think about “Extreme” LV dysfunction !
Posted Dec 18 2011 10:18am
Aorta is connected to the left ventricle like a hose pipe.The energy generated within the LV myocardium is efficiently delivered to the root of the aorta. Mechano -coupling of LV with aorta is important means by which blood is is ejected into systemic circulation .
Even though aorta has mainly passive contraction and ( The wind- kessel effect) , the most powerful contractile force of aorta comes from the transfer of kinetic energy from left ventricle .
This helps us to measure the LV function simply by looking at the aortic wall motion.Since aorta is the final common exit for LV it effectively represents the global LV function . The ubiquitous errors during LV border tracing and it’s subsequent mathematical amplification can be avoided. Here is a patient with severe LV dysfunction whose aortic motion is depicted . We refer to this as ” rail roading” sign of Aorta which implies a critically dysfunctional LV . His EF was 23 % The aortic motion is esepcailly useful in categorizing severe LV dysfunction from moderate LV dysfunction (The sensitivity we feel is as high as sophisticated tissue motion Doppler protocols .Of course it may lack specificity !* as hardened aorta due to aging can confound the aortic motion )